Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece; Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, Patras, Greece.
Division of Infectious Diseases, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Am J Pathol. 2023 Jun;193(6):656-668. doi: 10.1016/j.ajpath.2023.02.004. Epub 2023 Mar 1.
Studies of systemic autoimmune diseases point to characteristic microbial patterns in various diseases, including inflammatory bowel disease (IBD). Autoimmune diseases, and IBD in particular, show a predisposition to vitamin D deficiency, leading to alterations in the microbiome and disruption of intestinal epithelial barrier integrity. This review examines the role of the gut microbiome in IBD and discusses how vitamin D-vitamin D receptor (VDR)-associated molecular signaling pathways contribute to the development and progression of IBD through their effects on gut barrier function, the microbial community, and immune system function. The present data demonstrate that vitamin D promotes the proper function of the innate immune system by acting as an immunomodulator, exerting anti-inflammatory effects, and critically contributing to the maintenance of gut barrier integrity and modulation of the gut microbiota, mechanisms that may influence the IBD development and progression. VDR regulates the biological effects of vitamin D and is related to environmental, genetic, immunologic, and microbial aspects of IBD. Vitamin D influences the distribution of the fecal microbiota, with high vitamin D levels associated with increased levels of beneficial bacterial species and lower levels of pathogenic bacteria. Understanding the cellular functions of vitamin D-VDR signaling in intestinal epithelial cells may pave the way for the development of new treatment strategies for the therapeutic armamentarium of IBD in the near future.
系统性自身免疫性疾病的研究指出，各种疾病（包括炎症性肠病[IBD]）中存在特征性的微生物模式。自身免疫性疾病，尤其是 IBD，容易出现维生素 D 缺乏，导致微生物组发生变化，并破坏肠道上皮屏障完整性。这篇综述探讨了肠道微生物组在 IBD 中的作用，并讨论了维生素 D-维生素 D 受体（VDR）相关分子信号通路如何通过对肠道屏障功能、微生物群落和免疫系统功能的影响，促进 IBD 的发生和进展。现有数据表明，维生素 D 通过充当免疫调节剂、发挥抗炎作用以及对维持肠道屏障完整性和调节肠道微生物群至关重要，从而促进固有免疫系统的正常功能，这些机制可能影响 IBD 的发生和进展。VDR 调节维生素 D 的生物学效应，与 IBD 的环境、遗传、免疫和微生物方面有关。维生素 D 影响粪便微生物群的分布，高维生素 D 水平与有益细菌种类增加和致病性细菌水平降低有关。了解维生素 D-VDR 信号在肠道上皮细胞中的细胞功能，可能为未来 IBD 的治疗武器库开发新的治疗策略铺平道路。
